Difference Between Subungual Hematoma and Melanoma

Subungual Hematoma and Melanoma are two medical conditions that can affect a person's nails. Both have varying causes, and treatment methods. Therefore, it is vital to grasp the difference between the two in order to be able to proceed with the correct treatment methods.

Subungual Hematoma

When blood starts to clog or collect underneath a finger or toe nail, the condition is referred to as Subungual Hematoma. Subungual means occurring in the fingernail or toenail, while Hematoma means clotted blood in an organ, or tissue. This condition leads to a discoloration beneath the nail, and forming a red/black/purple spot. Affected area is known to cause discomfort and pain to the person. The condition is not considered serious, however, by any means so there is not much reason to worry.

Symptoms of Subungual Hematoma

1. Pain and Discomfort: This is due to the pressure of blood collecting between the nail and the nail bed.
2. Discoloration: The affected nail may show a dark-colored discoloration, which can be red, or purple-black, or a mix of either under the nail in the affected area.
3. Swelling: There may be swelling of the tip of the affected finger or toe.

Causes of Subungual Hematoma

1. Forceful Impact: Any sudden or forceful impact to the finger or toe can potentially lead to subungual hematoma.
2. Crashing: Getting finger caught between two surfaces such as in the door.
3. Sports: Sports that involve sudden acceleration are prone to cause this.
4. Footwear: A tight pair of shoes can also put strain on toes and become a cause for this condition.
5. Running on Unlevelled Surface: Running or hiking uphill or downhill can cause this.

Treatment for Subungual Hematoma

1. Natural Healing: In most cases, Subungual Hematomas get resolved naturally without needing any medical attention.
2. Pain Killers: Pain relievers can be used until it is healed to relieve from swelling, pain and discomfort.
3. Trephining: In a few cases, it may be necessary to create a hole in the nail to drain out the blood.
4. Removal of Nail: This is only done if the nail itself is damaged.

Melanoma

Melanoma is another condition that may occur beneath a fingernail or toenail. Although, it is to be noted that Melanoma's occurrences in the nails is less likely as it is actually a type of skin cancer. It is the currently known deadliest type of skin cancer and usually occurs in the skin. It is formed from melanocytes, which are pigment-producing cells. It is a highly dangerous condition and should be immediately consulted by a professional.

Symptoms of Melanoma

ABCDEEFG is a mnemonic used to summarize the symptoms of Melanoma.

1. Asymmetry: Melanoma is non-symmetrical if divided in two halves from any direction
2. Border: Irregular borders appear on the spot
3. Color: A variety of colors have been noted to be possible.
4. Diameter: Usually, greater than 0.24 inches or 6 mm.
5. Evolving Over Time: If not treated in time, then it continues to evolved over time

The last EFGs denote symptoms of nodular melanoma

1. Elevated above skin surface
2. Firm to the touch
3. Growing

Causes of Melanoma

1. UV light: UV radiation from sun damages DNA, and increases the risk of melanoma. Tanning beds should be avoided.
2. Genetic Mutation: It has been noted that some type of gene mutations can increase the risk of Melanoma.
3. Family Tree: If the family has a history of Melanoma then the later generations are more prone to it.
4. Weak Immune System: A weak immune system makes people more prone to melanoma.

Treatment for Melanoma

1. Surgery: Surgery is performed to remove the tumor and to minimize the risk of reoccurrence.
2. Chemotherapy: Dacarbazine, Temozolomide, Nab-paclitaxel, and Paclitaxel are some types of drugs that can be used to kill the cancer cells.
3. Targeted Therapy: Genes that may create a pathway for the Melanoma to grow are targeted using drugs such as Vemurafenib and Dabrafenib.
4. Immunotherapy: The immune system is stimulated and enhanced against the cancer cells.
5. Radiation: Kilovoltage X-ray beams are commonly used for radiation therapy treatment in order to destroy the cancel cells.

Differences Between Subungual Hematoma and Melanoma

Conclusion

In conclusion, understanding the difference between a subungual hematoma and melanoma is critical for proper diagnosis and treatment. A subungual hematoma typically results from trauma, causing bleeding beneath the nail, leading to discoloration and pain. It is usually benign and resolves on its own or with minor intervention like nail trephination.

On the other hand, melanoma is a serious form of skin cancer that can also develop beneath the nail. Melanoma presents as a dark, irregularly shaped lesion and requires prompt medical attention for diagnosis and treatment. Differentiating between these conditions is essential due to the significant implications for prognosis and management.

Consulting a healthcare professional for proper evaluation and diagnosis is crucial if there are concerns about changes in the nails or skin. Early detection and appropriate management are key to achieving the best outcomes in either case.